Interpretation of tuberculosis (TB) surveillance data in Solomon Islands between 2016 and 2022 should be informed by local conditions, including pandemic disruptions in contact tracing. The TB surveillance data recently reported by Yanagawa et al. has features indicative of underdiagnosis. We thus advise caution in the interpretation of this data.

Blow flies, flesh flies, and house flies can provide excellent evidence for forensic entomologists and are also essential to the fields of public health, medicine, and animal health. In all questions, the correct identification of fly species is an important initial step. The usual methods based on morphology or even molecular approaches can reach their limits here, especially when dealing with larger numbers of specimens. Since machine learning already plays a major role in many areas of daily life, such as education, business, industry, science, and medicine, applications for the classification of insects have been reported. Here, we applied the decision tree method with wing morphometric data to construct a model for discriminating flies of three families [Calliphoridae, Sarcophagidae, Muscidae] and seven species [Chrysomya megacephala (Fabricius), Chrysomya rufifacies (Macquart), Chrysomya (Ceylonomyia) nigripes Aubertin, Lucilia cuprina (Wiedemann), Hemipyrellia ligurriens (Wiedemann), Musca domestica Linneaus, and Parasarcophaga (Liosarcophaga) dux Thomson]. One hundred percent overall accuracy was obtained at a family level, followed by 83.33% at a species level. The results of this study suggest that non-experts might utilize this identification tool. However, more species and also samples per specimens should be studied to create a model that can be applied to the different fly species in Thailand.

INTRODUCTION: Cancer is a pervasive global problem with significant healthcare utilisation and cost. Emergency departments (EDs) see large numbers of patients with oncologic emergencies and act as "gate-keepers" to subsequent hospital admissions. A proportion of such hospital admissions are rapidly discharged within 2 days and may be potentially avoidable. METHODS: Over a 6-month period, we conducted a retrospective audit of active cancer patients presenting to the ED with subsequent admission to the Department of Medical Oncology. Our aims were to identify independent factors associated with a length of stay ≤2 days; and characterise the clinical and resource needs of these short admissions. RESULTS: Among all medical oncology admissions, 24.4% were discharged within 2 days. Compared to longer stayers, patients with short admissions were significantly younger ( CONCLUSION Short admissions have low resource needs and may be managed in the ED. This may help save valuable inpatient bed-days and reduce overall healthcare costs.
Emergency Service, Hospital ; Hospitalization ; Humans ; Length of Stay ; Neoplasms/therapy* ; Patient Admission ; Retrospective Studies ; Singapore/epidemiology*

Although myiasis caused by the blow fly, Chrysomya bezziana Villeneuve (Diptera: Calliphoridae), has been reported in Thailand, all of the cases were human. This study described three cutaneous myiasis cases caused by C. bezziana in dogs in Chiang Mai province, northern Thailand. The removal of fly larvae together with specific treatment to cure all cases in this study was represented.

Domestic mites have been recognized as the most common allergen responsible for respiratory allergy. Herein, we report a case of anaphylaxis due to ingestion of dust mitecontaminated food. A 14-year-old boy presented to the Emergency Department with chest discomfort, wheezing, eyelid angioedema, and urticarial rash twice in a month after eating meals, including tempura fried squids and onion fritters (containing wheat flour, eggs, squid, and onion). Anaphylaxis had been diagnosed and successfully treated. The investigations showed that the patient was sensitive to house dust mites. Positive skin prick-to-prick test response to incriminated flour and negative tests to wheat allergen extract and uncontaminated flour were demonstrated. The microscopic analysis of causative cooking flour identified the presence of Dermatophagoides farinae. During the oral food challenge test, the patient was able to eat tempura-fried squids and onion fritters, made with uncontaminated flour, without any adverse reaction. Hence, oral ingestion of dust mite-contaminated food was the culprit of this severe allergic reaction.

Purpose: Nodal downstaging after preoperative therapy for gastric cancer has been shown to impart excellent prognosis, but this has not been validated in a national cohort. The role of neoadjuvant chemoradiation (NACR) in nodal downstaging remains unclear when compared with that of neoadjuvant chemotherapy alone (NAC). Furthermore, it is unknown whether the prognostic implications of nodal downstaging differ by preoperative regimen. Materials and Methods: Using the National Cancer Database, overall survival (OS) duration was compared among natural N0 (cN0/ypN0), downstaged N0 (cN+/ypN0), and nodepositive (ypN+) gastric cancer patients treated with NACR or NAC. Factors associated with nodal downstaging were examined in a propensity score-matched cohort of cN+ patients, matched 1:1 by receipt of NACR or NAC. Results: Of 7,426 patients (natural N0 [n=1,858, 25.4%], downstaged N0 [n=1,813, 24.4%], node-positive [n=3,755, 50.4%]), 58.2% received NACR, and 41.9% received NAC. The median OS durations of downstaged N0 (5.1 years) and natural N0 (5.6 years) patients were similar to one another and longer than that of node-positive patients (2.1 years) (P<0.001). In the matched cohort of cN+ patients, more recent diagnosis (2010–2015 vs. 2004–2009) (odds ratio [OR], 2.57; P<0.001) and NACR (OR, 2.02; P<0.001) were independently associated with nodal downstaging. The 5-year OS rate of downstaged N0 patients was significantly lower after NACR (46.4%) than after NAC (57.7%) (P=0.003). Conclusions Downstaged N0 patients have the same prognosis as natural N0 patients.Nodal downstaging occurred more frequently after NACR; however, the survival benefit of nodal downstaging after NACR may be less than that when such is achieved by NAC.

Insect blood cells or hemocytes play an important role in the defense against parasites and other pathogenic organisms. However, the hemocyte types of three mosquito vectors, Aedes togoi, Anopheles lesteri and Culex quinquefasiatus are not well known. Therefore, the aim of this study was to characterize the hemocytes of these three mosquito species based on morphology using light microscopy. The abdominal cutting and perfusion method was used in this study as it took the fewest steps, provided the largest number of hemocytes and yielded less contamination with fat body cells. Hemocyte typing, based on morphology, revealed three types of hemocytes (prohemocytes, oenocytoids and granulocytes) that were contained in the hemolymph of all three mosquito species. This study demonstrated that the use of distinct morphology with light microscopy provided sufficient criteria to characterize and differentiate mosquito hemocytes. This technique will be useful in terms of cost saving and for new researchers who begin to study in this field.

BACKGROUNDHuman adenoviruses (HAdVs) can cause a variety of human illnesses, with associated temporal and geographic changes in disease incidence. We report the emergence of an outbreak of HAdV infections in Singapore, presumably caused by a change of the predominating type to HAdV-7. We examined the clinical features of children admitted with HAdV infection to 1 institution and the risk factors for severe infection.

MATERIALS AND METHODSThis is a retrospective case-control study of all HAdV-infected children admitted during weeks 1 to 19 in 2013, as identified from laboratory records. A descriptive retrospective analysis of epidemiology, clinical data and the outcome of these children was also performed. Patients with severe infections were defined as cases, those with non-severe infections as controls, and the 2 groups were compared to find possible independent risk factors.

RESULTSEighty-five patients with HAdV infection were studied, including 11 (12.9%) cases and 74 (87.1%) controls. Binary logistic regression showed that cases were more likely to be <2 years old (adjusted OR 10.6, 95% CI, 1.8 to 63.2) and to have significant comorbidities (adjusted OR 19.9, 95% CI, 3.4 to 116.1) compared to controls. The predominant type in 2013 was HAdV-7, which differed from 2011 and 2012, when HAdV-3 was more common. There was a trend towards pneumonia being more common in patients infected with HAdV-7 than in patients infected with other types, although this did not reach statistical significance (OR 2.8, 95% CI, 0.9 to 8.7).

CONCLUSIONThe emergence of HAdV-7 in a population where other HAdV types had circulated previously may have caused the outbreak in Singapore, and this was associated with more serious infections in children. Young age (<2 years) and significant comorbidities were associated with more severe HAdV infection.

Adenoviridae Infections ; epidemiology ; virology ; Adenoviruses, Human ; genetics ; pathogenicity ; Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Comorbidity ; Disease Outbreaks ; Female ; Humans ; Immunocompromised Host ; Infant ; Male ; Retrospective Studies ; Severity of Illness Index ; Singapore ; epidemiology

Genes encoding the cellobiohydrolase enzyme (CBHI), designated as cbhI, were isolated from the basidiomycetes Auricularia fuscosuccinea, Pleurotus giganteus, P. eryngii, P. ostreatus, and P. sajor-caju. Initially, the fungal genomic DNA was extracted using a modified cetyltrimethyl ammonium bromide (CTAB) protocol and used as a DNA template. The cbhI genes were then amplified and cloned using the pGEM-T Easy Vector Systems. The sizes of these PCR amplicons were between 700~800 bp. The DNA sequences obtained were similar showing high identity to the cbhI gene family. These cbhI genes were partial consisting of three coding regions and two introns. The deduced amino acid sequences exhibited significant similarity to those of fungal CBHI enzymes belonging to glycosyl hydrolase family 7.
Amino Acid Sequence ; Base Sequence ; Basidiomycota ; Bromides ; Cellulase ; Cellulose 1,4-beta-Cellobiosidase ; Clinical Coding ; Clone Cells ; Cloning, Organism ; DNA ; Humans ; Introns ; Pleurotus ; Polymerase Chain Reaction ; Quaternary Ammonium Compounds ; Sequence Analysis

Food allergy is defined as reaction to a food which has an immunologic mechanism. Its prevalence is increasing in children globally and is therefore of increasing clinical importance. A useful clinical approach is to distinguish food allergic reactions by the timing of clinical reaction in relation to food exposure and classified as immediate (generally IgE-mediated) and delayed (generally non-IgE-mediated), with the exception of eczema and eosinophilic gastrointestinal disease, which, when associated with food allergy may be associated with either mechanism. This review is aimed at providing the clinician with a Singaporean perspective on the clinical approach and management of these disorders.
Breast Feeding ; Child ; Child, Preschool ; Eczema ; diagnosis ; immunology ; Food Hypersensitivity ; diagnosis ; prevention & control ; Humans ; Hypersensitivity, Delayed ; diagnosis ; prevention & control ; Immunoglobulin E ; blood ; Infant ; Infant, Newborn ; Skin Test End-Point Titration